Steps Taken to Expand PHCs and CHCs in Underserved Areas

1. At a Glance

• PHCs (Primary Health Centres) and CHCs (Community Health Centres) form the rural public healthcare backbone under the three-tier system (SHC → PHC → CHC) [2][3].
• The Centre supplements State efforts via the National Health Mission (NHM), approving State proposals through Programme Implementation Plans (PIPs) and Records of Proceedings (RoPs) [1].
• Examinable because it links Ayushman Bharat, IPHS 2022, eSanjeevani, and federal health financing — all GS-II staples.

2. Why in the News

• PIB release (10 Feb 2026) titled "Steps Taken to Expand PHCs and CHCs in Underserved Areas" by MoHFW highlighting >1.82 lakh Ayushman Arogya Mandirs (AAMs) operational, free diagnostics/drugs, ambulances, mobile medical units, and telemedicine [1].
• As of 31 December 2025, 1,82,944 AAMs stand operationalised by upgrading SHCs and PHCs [2].

3. Background & Evolution

• 1977 — Alma-Ata Declaration → primary healthcare framework adopted in India.
• 1983 / 2002 / 2017 — National Health Policies; 2017 NHP set 2.5% of GDP public health spend goal.
• 2005 — National Rural Health Mission (NRHM) launched; 2013 expanded to NHM (NRHM + NUHM).
• 2007 — first Indian Public Health Standards (IPHS) notified for SHC/PHC/CHC; revised 2012, 2022 [3].
• 2018 — Ayushman Bharat launched: SHCs/PHCs upgraded to Health & Wellness Centres (HWCs); PMJAY insurance arm [4].
• 2023 — HWCs rebranded as Ayushman Arogya Mandirs (AAMs) delivering 12-package Comprehensive Primary Health Care.

4. Core Static Facts

• Implementing Ministry: Ministry of Health & Family Welfare (MoHFW); Health is a State Subject (Entry 6, State List) — Centre acts via NHM/CSS [1].
• Three-tier rural structure (per IPHS-2022): Sub-Health Centre (5,000 pop; 3,000 hilly/tribal); PHC (30,000; 20,000 hilly); CHC (1,20,000; 80,000 hilly) [3].
• CHC norm: 30-bed referral with 4 specialists — Surgeon, Physician, Gynaecologist, Paediatrician.
• AAMs operational: 1,82,944 (as on 31 Dec 2025) [2].
• Block Public Health Units (BPHUs): 3,382 sanctioned; 730 District Integrated Public Health Labs envisaged (one per district) under PM-ABHIM [2].
• PMJAY cover: ₹5 lakh/family/year; 1,393 packages across 24 specialties [4].
• eSanjeevani: National telemedicine platform; doctor-to-doctor hub-and-spoke from AAMs; integrated with ABDM/ABHA [4].
• Funding pattern (NHM): 60:40 (Centre:State) for general States; 90:10 for NE & Himalayan States.

5. Multi-Dimensional Analysis

Administrative

• Centre supports via NHM PIP-RoP mechanism; gaps in human resources flagged in Rural Health Statistics 2021-22 [3].
• Multi-skilling of MBBS doctors under NHM to plug specialist shortage at CHCs [3].
• Hard-area allowance for specialists posted in remote/tribal blocks [3].

Social / Equity

• Differential population norms (3,000/20,000/80,000) for hilly, tribal, desert areas reduce access gap [3].
• Mobile Medical Units (MMUs) and free ambulance services (Dial 102/108) target last-mile populations [1].

Economic

• Free Drugs & Diagnostics Service Initiative (FDSI) cuts out-of-pocket expenditure (OOPE) — India's OOPE remains a major impoverisher [4].
• PMJAY reduces catastrophic hospitalisation expenditure for bottom 40% households [4].

Scientific / Technological

• eSanjeevani delivers tele-specialist care to AAMs; integrated with Ayushman Bharat Digital Mission (ABDM) & ABHA IDs [4].

Legal / Constitutional

• Health = State List Entry 6; DPSP Art. 47 (improve public health); Art. 21 read with right to health (SC: Paschim Banga Khet Mazdoor Samity, 1996).
• Quality benchmarks via IPHS 2022 (non-statutory but binding under NHM grants) [3].

6. Recent Developments (last 12-18 months)

• 10 Feb 2026 — PIB statement reiterating PIP/RoP route & last-mile measures [1].
• 31 Dec 2025 — AAM tally at 1,82,944 [2].
• 2025 — MoHFW Initiatives & Achievements-2025 compendium released (Jan 2026) [2].
• Ongoing rollout of PM-ABHIM (₹64,180 cr, 2021–26) creating 17,788 rural HWCs, 11,024 urban HWCs, 3,382 BPHUs, 602 critical care blocks, 730 IPHLs.
• IPHS-2022 revision operationalised across States — first major IPHS update in a decade [3].

7. Prelims Hooks

• AAM = renamed Ayushman Bharat-HWC; rebranded 2023 [2].
• Operational AAMs as on 31 Dec 2025: 1,82,944 [2].
• PHC population norm (plains): 30,000 [3].
• CHC population norm (plains): 1,20,000 [3].
• CHC = 30-bed referral with 4 specialists.
• IPHS first issued 2007, revised 2012 and 2022 [3].
• NHM funding: 60:40 general / 90:10 NE & Himalayan.
• PMJAY cover: ₹5 lakh/family/year; 1,393 packages [4].
• eSanjeevani = MoHFW's telemedicine service; integrated with ABDM [4].
• PM-ABHIM envisages 730 District Integrated Public Health Labs [2].
• BPHUs sanctioned: 3,382 [2].
• Health is Entry 6, State List; Centre routes funds via PIP-RoP under NHM [1].
• Dial 102 = pregnant women/infant transport; Dial 108 = emergency response.
• Implementing body for PMJAY = National Health Authority (NHA) — NOT MoHFW directly.

8. Mains Relevance

• GS-II: Issues relating to development and management of Social Sector — Health; Government policies and interventions; Welfare schemes for vulnerable sections.
• GS-III: Inclusive growth (OOPE reduction).
• Possible question stems: 1. "Despite IPHS norms, rural India faces a chronic shortfall of specialists at CHCs. Critically examine the steps taken under NHM to bridge this gap." 2. "Ayushman Arogya Mandirs mark a paradigm shift from selective to comprehensive primary healthcare. Discuss." 3. "Evaluate the role of telemedicine (eSanjeevani) and PM-ABHIM in strengthening last-mile healthcare in underserved areas."

9. Related Topics to Study Next

• Ayushman Bharat PMJAY — insurance arm complementing AAM primary care.
• PM-ABHIM (PM Ayushman Bharat Health Infrastructure Mission) — capital-side infra push.
• Ayushman Bharat Digital Mission (ABDM) & ABHA — digital backbone.
• National Health Policy 2017 — sets 2.5% GDP target.
• Rural Health Statistics (annual) — primary data source on PHC/CHC shortfalls.
• 15th Finance Commission health grants — ₹70,051 cr to local bodies for primary health.
• Janani Suraksha Yojana / Janani Shishu Suraksha Karyakram — demand-side maternal schemes.
• IPHS 2022 — quality benchmark framework.

10. Common Errors / Trap Areas

• Confusing AAM with PMJAY: AAM = primary care facility; PMJAY = secondary/tertiary insurance.
• Wrong SHC population norm: it is 5,000 (3,000 hilly), not 10,000.
• PMJAY is implemented by NHA, not directly by MoHFW.
• eSanjeevani is run by MoHFW (C-DAC Mohali), not by NITI Aayog or NHA.
• Health is on the State List (Entry 6) — the Centre's role is supportive via NHM, NOT executive.
• IPHS is 2022 (current), not 2012 — easy date trap.